Double-balloon enteroscope (DBE)-assisted endoscopic retrograde cholangiopancreatography (ERCP) is an effective endoscopic approach for pancreatobiliary disorders in patients with altered gastrointestinal anatomy. End...Double-balloon enteroscope (DBE)-assisted endoscopic retrograde cholangiopancreatography (ERCP) is an effective endoscopic approach for pancreatobiliary disorders in patients with altered gastrointestinal anatomy. Endoscopic interventions via DBE in these postoperative settings remain difficult because of the lack of an elevator and the use of extra-long ERCP accessories. Here, we report the usefulness of direct cholangioscopy with an ultra-slim gastroscope during DBE-assisted ERCP. Three patients with choledocholithiasis in postoperative settings (two patients after Billroth Ⅱ gastrojejunostomy and one patient after Roux-en-Y gastrojejunostomy) were treated. DBE was used to gain access to the papilla under carbon dioxide insufflation, and endoscopic sphincterotomy was performed with a conventional sphincterotome. For direct cholangioscopy, the enteroscope was exchanged for an ultra-slim gastroscope through an incision in the overtube, which was inserted directly into the bile duct. Direct cholangioscopy was used to extract retained bile duct stones in two cases and to confirm the complete clearance of stones in one case. Bile duct stones were eliminated with a 5-Fr basket catheter under direct visual control. No adverse events were noted in any of the three cases. Direct cholangioscopy with an ultra-slim gastroscope facilitates subsequent treatment within the bile duct. This procedure represents another potential option during DBE-assisted ERCP.展开更多
Endoscopic submucosal dissection(ESD) is the most advanced and representative technique in the field of therapeutic endoscopy and has been used for the treatment of gastrointestinal neoplasms,including early gastric c...Endoscopic submucosal dissection(ESD) is the most advanced and representative technique in the field of therapeutic endoscopy and has been used for the treatment of gastrointestinal neoplasms,including early gastric cancer.The major difference and advantage of ESD compared to existing endoscopic resection techniques,such as endoscopic mucosal resection(EMR) and polypectomy,are the width and depth of the resection.Newly developed cutting devices,distal attachable endoscopic accessories,and an advanced electrosurgical unit have helped to overcome the limitations of therapeutic endoscopy in terms of lesion size,location,presence of fibrotic scarring,and accompanying ulcers.As a result,the indications for ESD have been expanded from the classical indication for EMR and polypectomy,and there is now support for a further expansion of ESD indications.At present,the most critical factor to consider in the decision of whether to perform ESD is the probability of unexpected lymph node metastasis.The guidelines for ESD are continually being updated and debated.In this review,we discuss the strengths and weaknesses of the expanded guidelines,based on evidence found in the literature.展开更多
AIM: To investigate the effect of serum derived from rats treated with electroacupuncture at stomach meridian acupoints on the expression of epidermal growth factor receptor (EGFR) gene in gastric mucosal cells. METHO...AIM: To investigate the effect of serum derived from rats treated with electroacupuncture at stomach meridian acupoints on the expression of epidermal growth factor receptor (EGFR) gene in gastric mucosal cells. METHODS: The stress-induced gastric mucosal injury in rat model was established by water-immersion and restrained stress methods. 52 rats were randomly divided into: normal group (n = 8), model group (n = 8), model serum group (n = 12), stomach serum group (n = 12), and gallbladder serum group (n = 12). The gastric mucosal cells were separated by pronase-EDTA digestion method and incubated with serum. The EGFR gene expression in gastric mucosal cells was detected by reverse transcription-polymerase chain reaction (RT-PCR) method. RESULTS: Compared with normal group (0.6860 ± 0.0594), the serum derived from rats of the stomach group (1.2272 ± 0.0813, P = 0.00 < 0.01) and gallbladder group (0.9640 ± 0.0387, P = 0.00 < 0.01) had a tendency to enhance the EGFR gene expression in gastric mucosal cells. Such tendency existed in the model group (0.7104 ± 0.0457) but with no signifi cant difference (P = 0.495 > 0.05) and in model serum group (0.8516 ± 0.0409) with an extremely obvious difference (P = 0.001 < 0.01). Furthermore, the EGFR gene expression in stomach serum group was significantly higher than that in gallbladder serum group (P = 0.00 < 0.01). CONCLUSION: The present study shows that serumderived from rats treated with electroacupuncture at stomach meridian acupoints can distinctly increase the EGFR gene expression of gastric mucosal cells. Therefore, there is certain meridian specificity in the serum, which could provide a proof for the TCM theory “particular relation between meridian and internal organ”.展开更多
AIM: To evaluate the clinical role of 18F-fluorodeo-xyglucose positron emission and computed tomography (18F-FDG PET/CT) in detection of gastric cancer recurrence after initial surgical resection. METHODS: In the peri...AIM: To evaluate the clinical role of 18F-fluorodeo-xyglucose positron emission and computed tomography (18F-FDG PET/CT) in detection of gastric cancer recurrence after initial surgical resection. METHODS: In the period from January 2007 to May 2008, 23 patients who had previous surgical resection of histopathologically diagnosed gastric cancer underwent a total of 25 18F-FDG PET/CT scans as follow-up visits in our center. The standard of reference for tumor recurrence consisted of histopathologic confirmation or clinical follow-up information for at least 5 mo after PET/CT examinations. RESULTS: PET/CT was positive in 14 patients (61%) and negative in 9 (39%). When correlated with final diagnosis, which was confirmed by histopathologic evidence of tumor recurrence in 8 of the 23 patients (35%) and by clinical follow-up in 15 (65%), PET/CT was true positive in 12 patients, false positive in 2, true negative in 8 and false negative in 2. Overall, the accuracy of PET/CT was 82.6%, the negative predictive value (NPV) was 77.7%, and the positive predictive value (PPV) was 85.7%. The 2 false positive PET/CT findings were actually chronic inflammatory tissue lesions. For the two patients with false negativePET/CT, the f inal diagnosis was recurrence of mucinous adenocarcinoma in the anastomosis in one patient and abdominal wall metastasis in the other. Importantly, PET/CT revealed true-positive findings in 11 (47.8%) patients who had negative or no definite findings by CT. PET/CT revealed extra-abdominal metastases in 7 patients and additional esophageal carcinoma in one patient. Clinical treatment decisions were changed in 7 (30.4%) patients after introducing PET/CT into their conventional post-operative follow-up program. CONCLUSION: Whole body 18F-FDG PET/CT was highly effective in discriminating true recurrence in post-operative patients with gastric cancer and had important impacts on clinical decisions in a considerable portion of patients.展开更多
Endoscopic submucosal dissection(ESD) is a highly refined technique compared to conventional endoscopic mucosal resection.It enables complete resection of early gastric cancer(EGC) which has no possibility of lymph no...Endoscopic submucosal dissection(ESD) is a highly refined technique compared to conventional endoscopic mucosal resection.It enables complete resection of early gastric cancer(EGC) which has no possibility of lymph node metastasis.Indication for ESD of EGC generally entails early gastric cancer confined to the mucosa with well differentiated histology,though there are clinically suitable expanded criteria.As ESD requires specific skill and expertise,endoscopists need to be familiarized with basic methods and the use of special devices.The essence of the technique is to dissect the submucosal layer with direct vision and maintain thecutting plane above the underlying proper muscle layer.Although there are some differences in the detailed technical aspect,the cardinal method of ESD is now well established and standardized.Furthermore,research and development of new ESD devices that render more efficient,safe ESD are still in progress to improve the overall result of ESD on early gastric cancer.展开更多
OBJECTIVE To examine the ultrastructure of gastric cancer ceils by the electron microscope, in order to assess the relationship between neuroendocrine differentiation and post-operative survival time. METHODS NSE, Syn...OBJECTIVE To examine the ultrastructure of gastric cancer ceils by the electron microscope, in order to assess the relationship between neuroendocrine differentiation and post-operative survival time. METHODS NSE, Syn and CgA immunohistochemical labeling was conducted in 168 cases with a common-type of gastric cancer. Electron microscopy was performed in 80 cases with positive immunohistochemical labeling. These cases were followed-up for over 5 years and the post-operative survival data analyzed. RESULTS Neuroendocrine granules were found by electron microscopy in 39 cases. The rate of neuroendocrine differentiation found was 23% （39/168）, using routine diagnostic criteria and electron microscopy （REM）. The post-operative survival time of gastric cancer patients with neuroendocdne differentiation was significantly shorter （P=-0.0032） compared to those without neuroendocrine differentiation. CONCLUSION It is of significant clinical importance to determine if the neuroendocrine cells are differentiated in gastdc cancers. The gastric cancer patients with neuroendocrine differentiation have a shorter post-operative survival time and a poorer prognosis. Electron microscopy is a reliable method of providing a diagnosis.展开更多
AIM:To establish a rat ethanol gastritis model,we evaluated the effects of ethanol on gastric mucosa and studied the preventive effects of geranylgeranylacetone on ethanol-induced chronic gastritis.METHODS:One hundred...AIM:To establish a rat ethanol gastritis model,we evaluated the effects of ethanol on gastric mucosa and studied the preventive effects of geranylgeranylacetone on ethanol-induced chronic gastritis.METHODS:One hundred male Sprague-Dawley rats were randomly divided into 4 equal groups:normal control group,undergoing gastric perfusion of normal saline(NS) by gastrogavage;model control group and 2 model therapy groups that underwent gastric perfusion with ethanol(distillate spirits with 56% ethanol content) by gastrogavage for 4 wk.Low or high doses of geranylgeranylacetone were added 1 h before ethanol perfusion in the 2 model therapy groups,while the same amount of NS,instead of geranylgeranylacetone was used in that model control group.The rats were then sacrificed and stomachs were removed.The injury level of the gastric mucosa was observed by light and electron microscopy,and the levels of prostaglandin 2(PGE 2),endothelin-1(ET-1) and nitric oxide(NO) were measured by radioimmunoassay and the Griess method.RESULTS:The gastric mucosal epidermal damage score(EDS;4.5) and ulcer index(UI;12.0) of the model control group were significantly higher than that of the normal control group(0 and 0 respectively,all P = 0.000).The gastric mucosal EDS and UI of the 2 model therapy groups(EDS:2.5 and 2.0;UI:3.5 and 3.0) were significantly lower than that of the model control group(all P < 0.01).There was no statistically significant difference between the low-dose and high-dose model therapy groups.The expression value of plasma ET-1 of the model control group was higher than that of the normal control group(P < 0.01) and the 2 model therapy groups(all P < 0.01).The expression values of gastric mucosal PGE 2 and serum NO of the model control group were lower than those of the normal control group(all P < 0.05) and the 2 model therapy groups(all P < 0.05).The thickness of the gastric mucous layerand the hexosamine content in the model control group were significantly lower than that in the normal control group(all P < 0.01) and the 2 model therapy groups(all P < 0.05).Scanning and transmission electron microscopy observation showed that in the model control group,the epithelial junctions were vague,the intercellular joints disappeared and damage of the intracellular organelles were significantly worse than those in the normal control group.However,in the 2 model therapy groups,damage to the intercellular joints and organelles was ameliorate relative to the model control group.CONCLUSION:Administration of geranylgeranylacetone was correlated with a more favorable pattern of gastric mucosa damage after ethanol perfusion.The mechanism could be related to regulation of ET-1,NO and PGE 2.展开更多
A/M： To investigate the intercellular spaces between the most superficially located esophageal epithelial cells in patients with gastroesophageal reflux disease （GERD）. METHODS： Eighteen patients with erosive esop...A/M： To investigate the intercellular spaces between the most superficially located esophageal epithelial cells in patients with gastroesophageal reflux disease （GERD）. METHODS： Eighteen patients with erosive esophagitis, 10 patients with non-erosive reflux disease （NERD）, and 18 normal asymptomatic volunteers were enrolled. Biopsy specimens were obtained from the lower esophageal mucosa without ulcer or erosion. Scanning electron microscopy was employed to investigate the tightness of the superficial cellular attachment. RESULTS： The intercellular space between the most superficially located epithelial cells in patients with erosive esophagitis or NERD was not different from that in asymptomatic healthy individuals. CONCLUSION： Widened luminal intercellular spaces of esophageal superficial epithelium are not responsible for the induction of reflux symptoms in patients with GERD.展开更多
An isolated parenchymal gastric metastasis from ovarian carcinoma without any other sites of recurrence is extremely rare. Only two cases have been reported, both of which were symptomatic. We herein report such a cas...An isolated parenchymal gastric metastasis from ovarian carcinoma without any other sites of recurrence is extremely rare. Only two cases have been reported, both of which were symptomatic. We herein report such a case without any symptoms. A 61-year-old woman presented with a high cancer antigen-125 level without any other clinical manifestation. A subsequent 18 F-fluorodeoxyglucose (18F-FDG) positron emission tomography/computed tomography scan revealed a submucosal mass with hypermetabolism of 18F-FDG (standardized uptake value:5.36) in the gastric antrum. The final pathology after gastric antrectomy showed a metastatic gastric tumor from a primary ovarian carcinoma. We also performed an extensive literature review about gastric metastasis from ovarian carcinoma published until recently, and this is the first case of an isolated parenchymal gastric metastasis from ovarian carcinoma without any symptoms.展开更多
AIM： To evaluate the chemopreventive effects of aqueous Azadimchta indica （A indica） leaf extract （AAILE） against benzo（a）pyrene [B（a）P]-induced forestomach tumorigenesis in Balb/c mice. METHODS： Female Balb...AIM： To evaluate the chemopreventive effects of aqueous Azadimchta indica （A indica） leaf extract （AAILE） against benzo（a）pyrene [B（a）P]-induced forestomach tumorigenesis in Balb/c mice. METHODS： Female Balb/c mice were divided into four groups of 10-12 animals each. For induction of forestomach tumors, starting from d 14 of the experiment, mice of B（a）P and B（a）P＋A indica groups were given intra-gastric instillations of B（a）P （40 mg/kg）, twice a week for four weeks. Mice ofA indica and B（a）P＋A indica groups were orally administered with AAILE （100 mg/kg）, two weeks prior to B（a）P instillations till the end of the experiment. After 22 wk of the first B（a）P instillation, mice were sacrificed and the forestomachs were analyzed for development of tumors, scanning electron microscopy （SEM） and histopathology. RESULTS： Tumor incidence was observed to be 100% in mice that received only B（a）P. However, treatment with AAILE reduced the tumor incidence by 58.4% as observed in mice of B（a）P＋A indica group when compared to that of B（a）P group. Similarly, the tumor burden and multiplicity were seen to decrease by 87.3% and 69.6% respectively in mice of B（a）P＋A indica group when compared to those of B（a）P group. Scanning electron microscopy analysis showed that AAILE treatment itself did not cause any abnormalities on the surface architecture of forestomach epithelium. In tumorous forestomach, surface disruption was observed. Over the forestomach tumors of B（a）P group of mice certain rounded structures were seen in addition to closely placed tongue-shaped squamous cells. Interestingly, these rounded structures were not observed in B（a）P ＋ A indica group of mice. Histopathalogically, the tumors were identical and diagnosed to be papillomas. Mice from control and A indica groups of mice did not develop any forestomach tumors and showed normal histo-architecture. CONCLUSION： The present data suggest that A indica exerts chemopreventive effects against B（a）P-induced forestomach tumors in murine model. Because of lack of toxicity and ubiquitous bioavailability, A indica may play a promising role in future drug discovery and development as far as chemoprevention of cancer is concerned.展开更多
文摘Double-balloon enteroscope (DBE)-assisted endoscopic retrograde cholangiopancreatography (ERCP) is an effective endoscopic approach for pancreatobiliary disorders in patients with altered gastrointestinal anatomy. Endoscopic interventions via DBE in these postoperative settings remain difficult because of the lack of an elevator and the use of extra-long ERCP accessories. Here, we report the usefulness of direct cholangioscopy with an ultra-slim gastroscope during DBE-assisted ERCP. Three patients with choledocholithiasis in postoperative settings (two patients after Billroth Ⅱ gastrojejunostomy and one patient after Roux-en-Y gastrojejunostomy) were treated. DBE was used to gain access to the papilla under carbon dioxide insufflation, and endoscopic sphincterotomy was performed with a conventional sphincterotome. For direct cholangioscopy, the enteroscope was exchanged for an ultra-slim gastroscope through an incision in the overtube, which was inserted directly into the bile duct. Direct cholangioscopy was used to extract retained bile duct stones in two cases and to confirm the complete clearance of stones in one case. Bile duct stones were eliminated with a 5-Fr basket catheter under direct visual control. No adverse events were noted in any of the three cases. Direct cholangioscopy with an ultra-slim gastroscope facilitates subsequent treatment within the bile duct. This procedure represents another potential option during DBE-assisted ERCP.
文摘Endoscopic submucosal dissection(ESD) is the most advanced and representative technique in the field of therapeutic endoscopy and has been used for the treatment of gastrointestinal neoplasms,including early gastric cancer.The major difference and advantage of ESD compared to existing endoscopic resection techniques,such as endoscopic mucosal resection(EMR) and polypectomy,are the width and depth of the resection.Newly developed cutting devices,distal attachable endoscopic accessories,and an advanced electrosurgical unit have helped to overcome the limitations of therapeutic endoscopy in terms of lesion size,location,presence of fibrotic scarring,and accompanying ulcers.As a result,the indications for ESD have been expanded from the classical indication for EMR and polypectomy,and there is now support for a further expansion of ESD indications.At present,the most critical factor to consider in the decision of whether to perform ESD is the probability of unexpected lymph node metastasis.The guidelines for ESD are continually being updated and debated.In this review,we discuss the strengths and weaknesses of the expanded guidelines,based on evidence found in the literature.
基金Supported by the National Natural Science Foundation of China, No. 90209023 the State 973 Project, No. 2005CB523308
文摘AIM: To investigate the effect of serum derived from rats treated with electroacupuncture at stomach meridian acupoints on the expression of epidermal growth factor receptor (EGFR) gene in gastric mucosal cells. METHODS: The stress-induced gastric mucosal injury in rat model was established by water-immersion and restrained stress methods. 52 rats were randomly divided into: normal group (n = 8), model group (n = 8), model serum group (n = 12), stomach serum group (n = 12), and gallbladder serum group (n = 12). The gastric mucosal cells were separated by pronase-EDTA digestion method and incubated with serum. The EGFR gene expression in gastric mucosal cells was detected by reverse transcription-polymerase chain reaction (RT-PCR) method. RESULTS: Compared with normal group (0.6860 ± 0.0594), the serum derived from rats of the stomach group (1.2272 ± 0.0813, P = 0.00 < 0.01) and gallbladder group (0.9640 ± 0.0387, P = 0.00 < 0.01) had a tendency to enhance the EGFR gene expression in gastric mucosal cells. Such tendency existed in the model group (0.7104 ± 0.0457) but with no signifi cant difference (P = 0.495 > 0.05) and in model serum group (0.8516 ± 0.0409) with an extremely obvious difference (P = 0.001 < 0.01). Furthermore, the EGFR gene expression in stomach serum group was significantly higher than that in gallbladder serum group (P = 0.00 < 0.01). CONCLUSION: The present study shows that serumderived from rats treated with electroacupuncture at stomach meridian acupoints can distinctly increase the EGFR gene expression of gastric mucosal cells. Therefore, there is certain meridian specificity in the serum, which could provide a proof for the TCM theory “particular relation between meridian and internal organ”.
文摘AIM: To evaluate the clinical role of 18F-fluorodeo-xyglucose positron emission and computed tomography (18F-FDG PET/CT) in detection of gastric cancer recurrence after initial surgical resection. METHODS: In the period from January 2007 to May 2008, 23 patients who had previous surgical resection of histopathologically diagnosed gastric cancer underwent a total of 25 18F-FDG PET/CT scans as follow-up visits in our center. The standard of reference for tumor recurrence consisted of histopathologic confirmation or clinical follow-up information for at least 5 mo after PET/CT examinations. RESULTS: PET/CT was positive in 14 patients (61%) and negative in 9 (39%). When correlated with final diagnosis, which was confirmed by histopathologic evidence of tumor recurrence in 8 of the 23 patients (35%) and by clinical follow-up in 15 (65%), PET/CT was true positive in 12 patients, false positive in 2, true negative in 8 and false negative in 2. Overall, the accuracy of PET/CT was 82.6%, the negative predictive value (NPV) was 77.7%, and the positive predictive value (PPV) was 85.7%. The 2 false positive PET/CT findings were actually chronic inflammatory tissue lesions. For the two patients with false negativePET/CT, the f inal diagnosis was recurrence of mucinous adenocarcinoma in the anastomosis in one patient and abdominal wall metastasis in the other. Importantly, PET/CT revealed true-positive findings in 11 (47.8%) patients who had negative or no definite findings by CT. PET/CT revealed extra-abdominal metastases in 7 patients and additional esophageal carcinoma in one patient. Clinical treatment decisions were changed in 7 (30.4%) patients after introducing PET/CT into their conventional post-operative follow-up program. CONCLUSION: Whole body 18F-FDG PET/CT was highly effective in discriminating true recurrence in post-operative patients with gastric cancer and had important impacts on clinical decisions in a considerable portion of patients.
文摘Endoscopic submucosal dissection(ESD) is a highly refined technique compared to conventional endoscopic mucosal resection.It enables complete resection of early gastric cancer(EGC) which has no possibility of lymph node metastasis.Indication for ESD of EGC generally entails early gastric cancer confined to the mucosa with well differentiated histology,though there are clinically suitable expanded criteria.As ESD requires specific skill and expertise,endoscopists need to be familiarized with basic methods and the use of special devices.The essence of the technique is to dissect the submucosal layer with direct vision and maintain thecutting plane above the underlying proper muscle layer.Although there are some differences in the detailed technical aspect,the cardinal method of ESD is now well established and standardized.Furthermore,research and development of new ESD devices that render more efficient,safe ESD are still in progress to improve the overall result of ESD on early gastric cancer.
基金This work was supported by a grant from theSocial Development and Scientific Programof the Nantong Municipal Government,Ji-angsu Province,China(No.S30062).
文摘OBJECTIVE To examine the ultrastructure of gastric cancer ceils by the electron microscope, in order to assess the relationship between neuroendocrine differentiation and post-operative survival time. METHODS NSE, Syn and CgA immunohistochemical labeling was conducted in 168 cases with a common-type of gastric cancer. Electron microscopy was performed in 80 cases with positive immunohistochemical labeling. These cases were followed-up for over 5 years and the post-operative survival data analyzed. RESULTS Neuroendocrine granules were found by electron microscopy in 39 cases. The rate of neuroendocrine differentiation found was 23% （39/168）, using routine diagnostic criteria and electron microscopy （REM）. The post-operative survival time of gastric cancer patients with neuroendocdne differentiation was significantly shorter （P=-0.0032） compared to those without neuroendocrine differentiation. CONCLUSION It is of significant clinical importance to determine if the neuroendocrine cells are differentiated in gastdc cancers. The gastric cancer patients with neuroendocrine differentiation have a shorter post-operative survival time and a poorer prognosis. Electron microscopy is a reliable method of providing a diagnosis.
文摘AIM:To establish a rat ethanol gastritis model,we evaluated the effects of ethanol on gastric mucosa and studied the preventive effects of geranylgeranylacetone on ethanol-induced chronic gastritis.METHODS:One hundred male Sprague-Dawley rats were randomly divided into 4 equal groups:normal control group,undergoing gastric perfusion of normal saline(NS) by gastrogavage;model control group and 2 model therapy groups that underwent gastric perfusion with ethanol(distillate spirits with 56% ethanol content) by gastrogavage for 4 wk.Low or high doses of geranylgeranylacetone were added 1 h before ethanol perfusion in the 2 model therapy groups,while the same amount of NS,instead of geranylgeranylacetone was used in that model control group.The rats were then sacrificed and stomachs were removed.The injury level of the gastric mucosa was observed by light and electron microscopy,and the levels of prostaglandin 2(PGE 2),endothelin-1(ET-1) and nitric oxide(NO) were measured by radioimmunoassay and the Griess method.RESULTS:The gastric mucosal epidermal damage score(EDS;4.5) and ulcer index(UI;12.0) of the model control group were significantly higher than that of the normal control group(0 and 0 respectively,all P = 0.000).The gastric mucosal EDS and UI of the 2 model therapy groups(EDS:2.5 and 2.0;UI:3.5 and 3.0) were significantly lower than that of the model control group(all P < 0.01).There was no statistically significant difference between the low-dose and high-dose model therapy groups.The expression value of plasma ET-1 of the model control group was higher than that of the normal control group(P < 0.01) and the 2 model therapy groups(all P < 0.01).The expression values of gastric mucosal PGE 2 and serum NO of the model control group were lower than those of the normal control group(all P < 0.05) and the 2 model therapy groups(all P < 0.05).The thickness of the gastric mucous layerand the hexosamine content in the model control group were significantly lower than that in the normal control group(all P < 0.01) and the 2 model therapy groups(all P < 0.05).Scanning and transmission electron microscopy observation showed that in the model control group,the epithelial junctions were vague,the intercellular joints disappeared and damage of the intracellular organelles were significantly worse than those in the normal control group.However,in the 2 model therapy groups,damage to the intercellular joints and organelles was ameliorate relative to the model control group.CONCLUSION:Administration of geranylgeranylacetone was correlated with a more favorable pattern of gastric mucosa damage after ethanol perfusion.The mechanism could be related to regulation of ET-1,NO and PGE 2.
基金The Grants-in-Aid from Science Research from the Ministry of Education, Culture, Sports, Science and Technology of Japan, No. 19590724
文摘A/M： To investigate the intercellular spaces between the most superficially located esophageal epithelial cells in patients with gastroesophageal reflux disease （GERD）. METHODS： Eighteen patients with erosive esophagitis, 10 patients with non-erosive reflux disease （NERD）, and 18 normal asymptomatic volunteers were enrolled. Biopsy specimens were obtained from the lower esophageal mucosa without ulcer or erosion. Scanning electron microscopy was employed to investigate the tightness of the superficial cellular attachment. RESULTS： The intercellular space between the most superficially located epithelial cells in patients with erosive esophagitis or NERD was not different from that in asymptomatic healthy individuals. CONCLUSION： Widened luminal intercellular spaces of esophageal superficial epithelium are not responsible for the induction of reflux symptoms in patients with GERD.
文摘An isolated parenchymal gastric metastasis from ovarian carcinoma without any other sites of recurrence is extremely rare. Only two cases have been reported, both of which were symptomatic. We herein report such a case without any symptoms. A 61-year-old woman presented with a high cancer antigen-125 level without any other clinical manifestation. A subsequent 18 F-fluorodeoxyglucose (18F-FDG) positron emission tomography/computed tomography scan revealed a submucosal mass with hypermetabolism of 18F-FDG (standardized uptake value:5.36) in the gastric antrum. The final pathology after gastric antrectomy showed a metastatic gastric tumor from a primary ovarian carcinoma. We also performed an extensive literature review about gastric metastasis from ovarian carcinoma published until recently, and this is the first case of an isolated parenchymal gastric metastasis from ovarian carcinoma without any symptoms.
基金Supported by Council for Scientific and Industrial Research, New Delhi, India
文摘AIM： To evaluate the chemopreventive effects of aqueous Azadimchta indica （A indica） leaf extract （AAILE） against benzo（a）pyrene [B（a）P]-induced forestomach tumorigenesis in Balb/c mice. METHODS： Female Balb/c mice were divided into four groups of 10-12 animals each. For induction of forestomach tumors, starting from d 14 of the experiment, mice of B（a）P and B（a）P＋A indica groups were given intra-gastric instillations of B（a）P （40 mg/kg）, twice a week for four weeks. Mice ofA indica and B（a）P＋A indica groups were orally administered with AAILE （100 mg/kg）, two weeks prior to B（a）P instillations till the end of the experiment. After 22 wk of the first B（a）P instillation, mice were sacrificed and the forestomachs were analyzed for development of tumors, scanning electron microscopy （SEM） and histopathology. RESULTS： Tumor incidence was observed to be 100% in mice that received only B（a）P. However, treatment with AAILE reduced the tumor incidence by 58.4% as observed in mice of B（a）P＋A indica group when compared to that of B（a）P group. Similarly, the tumor burden and multiplicity were seen to decrease by 87.3% and 69.6% respectively in mice of B（a）P＋A indica group when compared to those of B（a）P group. Scanning electron microscopy analysis showed that AAILE treatment itself did not cause any abnormalities on the surface architecture of forestomach epithelium. In tumorous forestomach, surface disruption was observed. Over the forestomach tumors of B（a）P group of mice certain rounded structures were seen in addition to closely placed tongue-shaped squamous cells. Interestingly, these rounded structures were not observed in B（a）P ＋ A indica group of mice. Histopathalogically, the tumors were identical and diagnosed to be papillomas. Mice from control and A indica groups of mice did not develop any forestomach tumors and showed normal histo-architecture. CONCLUSION： The present data suggest that A indica exerts chemopreventive effects against B（a）P-induced forestomach tumors in murine model. Because of lack of toxicity and ubiquitous bioavailability, A indica may play a promising role in future drug discovery and development as far as chemoprevention of cancer is concerned.
